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A randomized controlled trial found that training with a 3D-printed model for laparoscopic biliary-enteric anastomosis led to significantly shorter operation times, higher performance scores, and greater goal achievement compared to traditional training methods. This suggests improved skill acquisition and transferability to a clinical setting with…
Researchers discuss current strategies and challenges in diagnosing and treating intraductal papillary neoplasms (IPNs) of the bile duct and pancreatic duct, which are precursors to pancreatic cancer and cholangiocarcinoma. Modern imaging, biomarkers, and molecular tests are aiding in diagnosis, but treatment should be individualized based…
Postoperative pancreatic fistula (POPF) is a common complication following pancreatectomy, with over sixty prediction models existing primarily for pancreaticoduodenectomy. However, these models have shown suboptimal accuracy across diverse populations. Future research should focus on developing and validating prediction models for distal and central pancreatectomy, incorporating…
Adjuvant chemotherapy following resection for adenocarcinoma from intraductal papillary mucinous neoplasia did not show reduced recurrence rates or improved survival outcomes in a multicenter study. Various chemotherapy regimens were not associated with superior outcomes in any high-risk subgroup, indicating that chemotherapy may not influence recurrence…
Researchers examined the concept of total neoadjuvant therapy (TNT) for pancreatic ductal adenocarcinoma (PDAC), finding that the term "total" is not consistently defined. Although it has gained popularity for its promise of comprehensive preoperative treatment, the current understanding and protocols vary widely, with inconsistent therapy…
Minimally invasive surgery for intrahepatic cholangiocarcinoma in patients at high risk of early recurrence provides better disease-free and overall survival compared to open surgery. Laparoscopic approach leads to shorter surgery-adjuvant treatment interval and higher rates of adjuvant therapy initiation within 2 months post-surgery. This study…
Highly complex liver resections (HCLR) can be performed with an acceptable complication profile, similar to major non-HCLR procedures. However, HCLR is associated with increased rates of biliary complications, readmissions, and reoperations. No postoperative 90-day mortality was observed in the HCLR group. Tertiary hepato-pancreato-biliary centers should…
Recent literature advocates for delaying catheter drainage in acute pancreatitis, but critically ill patients with severe disease and infected peri-pancreatic collections may still benefit from drainage procedures. A retrospective review of 72 patients showed high rates of ICU admission, respiratory and renal failure, and in-hospital…
Patients with small hepatocellular carcinoma showed similar overall and recurrence-free survival rates whether treated with laparoscopic liver resection or radiofrequency ablation. This randomized clinical trial suggests that percutaneous radiofrequency ablation may offer comparable therapeutic effects to laparoscopic liver resection for this patient population.
Researchers conducted a retrospective review of 394 microwave ablation (MWA) procedures on 328 patients with colorectal liver metastasis. The study found a low morbidity rate, with Clavien-Dindo grade III or IV complications occurring in 3.6% of patients, all of whom had concomitant procedures. Incomplete ablation…
